Monopolar versus bipolar transurethral resection of prostate for benign prostatic hyperplasia: Operative outcomes and surgeon preferences, a real-world scenario

Madduri, Vijay Kumar Sarma; Bera, Malay Kumar; Pal, Dilip Kumar

doi:10.4103/0974-7796.184900

Cited by 16 publications

(3 citation statements)

References 41 publications

(68 reference statements)

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“…This study concluded that bipolar TURP is better than monopolar TURP in terms of development of TURP syndrome and larger prostate glands need to be operated by bipolar TURP. 14 In our study also we concluded that larger prostate gland should be operated by bipolar TURP but on the basis of observation in our study, we derived a cutoff point of 50 grams of prostatic weight. Prostates having weight more than 50 grams must be operated by bipolar TURP and prostates having weight less than 50 grams can be operated by either monopolar TURP or bipolar TURP if we compare the result in terms of TURP syndrome development.…”

Section: Discussionmentioning

confidence: 68%

Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

Maurya

Kumar

2021

Asian J Med Sci

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Background: Transurethral resection of prostate is considered as gold standard surgical procedure for treatment of benign enlargement of prostate. It can be performed in two forms- monopolar transurethral resection and bipolar transurethral resection. Aims and Objective: This study was conducted to know which energy source among monopolar and bipolar energy leads to more post-operative morbidity after performing transurethral resection of prostate. Materials and Methods: In this study, total eighty (80) cases were included. They were suffering from lower urinary tract symptoms which were diagnosed to be due to benign enlargement of prostate after careful clinical and radiological examination. In forty cases, transurethral resection of prostate was performed by using monopolar energy source and in another forty cases, resection of prostate by transurethral route was done using bipolar energy source. Results: In our study, we found that development of TURP syndrome was more in monopolar TURP group in which pre-operative weight of prostate was more than 50 grams in comparison to bipolar TURP group in which there was no incidence of development of TURP syndrome in same class. Further, post-operative hospital stay and post-operative urethral catheter in situ was less in bipolar TURP group in terms of days as compared to monopolar TURP group. Conclusion: Our study concludes that Bipolar TURP is better in terms of development of less post-operative morbidity as compared to monopolar TURP. Bipolar TURP must be used extensively in teaching hospitals where students take more time than a seasoned surgeon to perform a surgical procedure and bipolar TURP will come handy in that situation.

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Section: Discussionmentioning

confidence: 68%

Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

Maurya

Kumar

2021

Asian J Med Sci

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“…The overall mean rates of transfusion, reoperation, and death were 0.1%, 0.2%, and 0.1%, respectively; these rates of perioperative complications are lower than those reported in previous studies. 24 25 …”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of the changes in the surgical treatment of benign prostatic hyperplasia during an 11-year period

Peng

Zhou

Song

et al. 2021

Asian Journal of Andrology

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The present study aimed to determine whether the number of patients with symptomatic benign prostatic hyperplasia (BPH) who preferred surgery decreased during the past 11 years at our center (West China Hospital, Chengdu, China), and whether this change affected the timing of surgery and the physical condition of surgical patients. This retrospective study included 57 557 patients with BPH treated from January 2008 to December 2018. Of these, 5427 patients were treated surgically. Surgical patients were divided into two groups based on the time of treatment (groups 8–13 and groups 13–18). The collected data comprised the percentage of all patients with BPH who underwent surgery, baseline characteristics of surgical patients, rehabilitation time, adverse events, and hospitalization costs. The surgery rates in groups 8–13 and groups 13–18 were 10.5% and 8.5% ( P < 0.001), respectively. The two groups did not clinically differ regarding patient age and prostate volume. The rates of acute urinary retention and renal failure decreased from 15.0% to 10.6% ( P < 0.001) and from 5.2% to 3.1% ( P < 0.001), respectively. In groups 8–13 and groups 13–18, the mean catheterization times were 4.0 ± 1.7 days and 3.3 ± 1.6 days ( P < 0.001), respectively, and the mean postoperative hospitalization times were 5.1 ± 2.4 days and 4.2 ± 1.8 days ( P < 0.001), respectively. The incidences of unplanned second surgery and death reduced during the study period. The surgery rate decreased over time, which suggests that medication was chosen over surgery. However, the percentage of late complications of BPH also decreased over time, which indicates that the timing of surgery was not delayed.

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“…Strengths of our study include the large number of patients and study centers covering the whole spectrum of routine care, thus reflecting the reality of everyday conditions better than results of randomized controlled trials from single tertiary care centers. Limitations include the lack of differentiation between mono- and bipolar TUR-P and between the different forms of LT. Data from the current literature suggest that most interventions are performed by a monopolar TUR-P [28]; similarly, holmium enucleation is the most commonly used form of LT [21, 29].…”

Section: Discussionmentioning

confidence: 99%

Perioperative Outcomes of Transurethral Resection, Open Prostatectomy, and Laser Therapy in the Surgical Treatment of Benign Prostatic Obstruction: A “Real-World” Data Analysis from the URO-Cert Prostate Centers

Herden¹,

Ebert²,

Schlager³

et al. 2021

Urol Int

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Introduction: The aim of the study is to compare length of hospital stay, transfusion rates, and re-intervention rates during hospitalization for transurethral resection of the prostate (TUR-P), open prostatectomy (OP), and laser therapy (LT) for surgical treatment of benign prostatic obstruction (BPO). Methods: URO-Cert is an organization, in which clinical data of prostatic diseases from 2 university, 19 public, and 3 private hospitals and 270 office-based urologists are collected in order to document treatment quality. Data on diagnostics, therapy, and course of disease are recorded web based. The analysis includes datasets from 2005 to 2017. Results: Of 10,420 patients, 8,389 were treated with TUR-P, 1,334 with OP, and 697 with LT. Median length of hospital stay was 6 days (IQR: 4–7) for TUR-P, 9 days (IQR: 7–11) for OP, and 5 days (IQR: 4–6) for LT (p < 0.001). Risk for a hospital stay ≥7 days was higher for OP versus TUR-P (OR: 7.25; 95% CI = 6.27–8.36; p < 0.001) and LT (OR: 17.89; 95% CI = 14.12–22.65; p < 0.001) and higher for TUR-P versus LT (OR: 2.47; 95% CI = 2.03–3.01; p < 0.001). OP had a significantly higher risk for transfusions than TUR-P (OR: 2.44; 95% CI = 1.74–3.41; p < 0.001) and LT (OR: 3.32; 95% CI = 1.56–7.01; p < 0.001). Transfusion rates were not significantly different between TUR-P and LT (OR: 1.36; 95% CI = 0.66–2.79; p = 0.51). Risk of re-intervention was not different between all 3 approaches. Conclusion: OP was associated with higher transfusion rates and longer hospital stay than TUR-P and LT. Risk of transfusion was not different between TUR-P and LT, but TUR-P was inferior to LT concerning length of hospital stay. Re-intervention rates during hospitalization did not differ between the groups.

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Monopolar versus bipolar transurethral resection of prostate for benign prostatic hyperplasia: Operative outcomes and surgeon preferences, a real-world scenario

Cited by 16 publications

References 41 publications

Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

Retrospective analysis of the changes in the surgical treatment of benign prostatic hyperplasia during an 11-year period

Perioperative Outcomes of Transurethral Resection, Open Prostatectomy, and Laser Therapy in the Surgical Treatment of Benign Prostatic Obstruction: A “Real-World” Data Analysis from the URO-Cert Prostate Centers

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